Enhancing Referral of Sexually Active Adolescent Females from the Emergency Department to Family Planning

Pregnancy should be considered in all adolescent females presenting to the emergency department. Roughly half of all teenagers report that they are sexually active. Pregnancy in teenagers has many unique risk factors and potential complications. Due to concerns about confidentiality, transportation, cost, embarrassment, and perception of judgment, teens are less likely to seek care for possible pregnancy. When they do seek care, they are more likely to present to the emergency department than to a primary care provider. They often present at a much more advanced gestational age compared to their adult counterparts. This chapter reviews several important complications in the diagnosis and management of pregnancy, associated complications, and details important management principles in the care of the pregnant teenager.

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Wealth-related inequalities in demand for family planning satisfied among married and unmarried adolescent girls and young women in sub-Saharan Africa

Reproductive Health ◽

10.1186/s12978-021-01076-0 ◽

2021 ◽

Vol 18 (S1) ◽

Author(s):

Martin K. Mutua ◽

Yohannes D. Wado ◽

Monica Malata ◽

Caroline W. Kabiru ◽

Elsie Akwara ◽

...

Keyword(s):

Family Planning ◽

West Africa ◽

Adolescent Girls ◽

Young Women ◽

Rate Of Change ◽

Sub Saharan Africa ◽

Demographic And Health Surveys ◽

Sexually Active ◽

Sub Saharan ◽

Over Time

Abstract Background The use of modern contraception has increased in much of sub-Saharan Africa (SSA). However, the extent to which changes have occurred across the wealth spectrum among adolescents is not well known. We examine poor-rich gaps in demand for family planning satisfied by modern methods (DFPSm) among sexually active adolescent girls and young women (AGYW) using data from national household surveys. Methods We used recent Demographic and Health Surveys and Multiple Indicator Cluster Surveys to describe levels of wealth-related inequalities in DFPSm among sexually active AGYW using an asset index as an indicator of wealth. Further, we used data from countries with more than one survey conducted from 2000 to assess DFPSm trends. We fitted linear models to estimate annual average rate of change (AARC) by country. We fitted random effects regression models to estimate regional AARC in DFPSm. All analysis were stratified by marital status. Results Overall, there was significant wealth-related disparities in DFPSm in West Africa only (17.8 percentage points (pp)) among married AGYW. The disparities were significant in 5 out of 10 countries in Eastern, 2 out of 6 in Central, and 7 out of 12 in West among married AGYW and in 2 out of 6 in Central and 2 out of 9 in West Africa among unmarried AGYW. Overall, DFPSm among married AGYW increased over time in both poorest (AARC = 1.6%, p < 0.001) and richest (AARC = 1.4%, p < 0.001) households and among unmarried AGYW from poorest households (AARC = 0.8%, p = 0.045). DPFSm increased over time among married and unmarried AGYW from poorest households in Eastern (AARC = 2.4%, p < 0.001) and Southern sub-regions (AARC = 2.1%, p = 0.030) respectively. Rwanda and Liberia had the largest increases in DPFSm among married AGYW from poorest (AARC = 5.2%, p < 0.001) and richest (AARC = 5.3%, p < 0.001) households respectively. There were decreasing DFPSm trends among both married (AARC = − 1.7%, p < 0.001) and unmarried (AARC = − 4.7%, p < 0.001) AGYW from poorest households in Mozambique. Conclusion Despite rapid improvements in DFPSm among married AGYW from the poorest households in many SSA countries there have been only modest reductions in wealth-related inequalities. Significant inequalities remain, especially among married AGYW. DFPSm stalled in most sub-regions among unmarried AGYW.

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Efficacy of the READY-Girls Program on General Risk-Taking Behaviors, Condom Use, and Sexually Transmitted Infections Among Young Adolescent Females With Type 1 Diabetes

The Diabetes Educator ◽

10.1177/0145721716668651 ◽

2016 ◽

Vol 42 (6) ◽

pp. 712-720 ◽

Cited By ~ 2

Author(s):

Jennifer Thurheimer ◽

Susan M. Sereika ◽

Sandra Founds ◽

Julie Downs ◽

Denise Charron-Prochownik

Keyword(s):

Condom Use ◽

Birth Control ◽

Risk Taking ◽

Adolescent Females ◽

Sexually Active ◽

Preconception Counseling ◽

Short Term ◽

Sexually Transmitted ◽

Risk Taking Behaviors

Purpose The purpose of this study is to examine the short-term efficacy (3 months) of early diabetes-specific READY-Girls preconception counseling (RGPC) on more general risk-taking behaviors, condom use, and sexually transmitted infections (STIs) among adolescent females with type 1 diabetes. Methods Secondary analysis was performed with data pooled from 2 independent randomized controlled trials to evaluate the short-term impact of RGPC. The pooled sample had 136 participants (mean age, 16.9 years; range, 13-19 years) and compared those who received the RGPC (n = 76) with a control group who received standard care (n = 60). Both groups self-reported on demographic characteristics, risk-taking behaviors (eg, substance use and unsafe sex), birth control, and STIs. Results No effect of RGPC emerged on risk-taking behaviors, condom use, and STIs. Only 25% (n = 36) of the adolescents were sexually active at baseline, and 29% (n = 39) were sexually active at 3 months. Their overall mean age of sexual debut was 15.4 years, with more than half reporting an episode of unprotected sex. Condoms were the most frequent type of birth control used by both groups at both time points. By 3 months, only 4 participants had been diagnosed with an STI. Over time, subjects in both groups became more sexually active and used more condoms. Conclusion RGPC did not appear to directly affect general risk-taking behaviors or STIs, since it focuses on diabetes and reproductive health issues. Condom use did increase over time in both groups. More information on risk-taking behaviors and STIs should be included in diabetes-specific preconception counseling programs, including RGPC.

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